Uveitis in Rheumatic Diseases

Claire      Hooper; Simon      Taylor; Sue      Lightman

doi:10.2174/157339711794474576

Abstract

Uveitis is a common extra-articular manifestation of many rheumatic diseases and can be associated with considerable morbidity, both in terms of vision loss and the need for systemic immunosuppression. Anterior uveitis is symptomatic in adults, presenting as a red, painful eye with photophobia, and is most commonly associated with HLAB27 disease. In contrast, chronic anterior uveitis can be silent in children with juvenile idiopathic arthritis, necessitating regular screening to detect its presence. Posterior segment inflammation carries a worse prognosis for vision, and usually manifests as floaters and visual impairment. This article reviews the pathophysiology and clinical features of uveitis occurring in association with systemic inflammatory disease, as well as discussing the current and emerging therapies available for treating its various manifestations.

Keywords: Uveitis, juvenile idiopathic arthritis, HLA-B27, Behcet's disease, sarcoidosis, autoimmune, rheumatic diseases, photophobia, iritis, iridocyclitis, vitritis, pars planitis, choroiditis, retinitis, retinal vasculitis, conjunctival hyperaemia, band keratopathy, chorioretinitis, optic nerve granulomas, papil-litis, Kawasaki disease, Blau syndrome, populations derived, rheumatoid, Lyme disease, tubercu-losis, cat scratch disease, brucellosis, posterior synechia, cataract, secondary ocular hypertension, glaucoma, hypotony, phthisis, Psoriatic arthritis, hepatosplenomegaly, vasculitis, cervical lymphadeno-pathy, meningoencephalitis, cryopyrin, interleukin-1 (IL-1), spondyloarthropathies, ankylosing spondylit, inflammatory bowel disease, sacroiliac joints, sacroiliitis, Reactive arthritis, Reiter's syndrome, PCR testing, enthesitis, axial arthropathy, Macular oedema, macular ischaemia, lacrimal glands, CT scan, bronchoscopy, bronchoalveolar, serum angiotensin converting enzyme, gallium scintigraphy, and tissue biopsy. The only diagnostic test is a biopsy show, Quantiferon gold, zoonosis, Human T-lymphotropic virus type 1 (HTLV-1), myelopathy, endophthalmitis, septic arthritis, echocardiogram, vancomycin, amikacin, ciprofloxacin, moxifloxacin, fluconazole, voriconazole, vitrectomy, prednisolone, Methotrexate, azathioprine, mycophenolate, Cyclophosphamide, chlorambucil, etaner-cept, infliximab, adalimumab, Crohn's disease, Daclizumab